M1: Issues Unique to the Newborn

Question 0

Newborn Mortality: severe immaturity

Answer 0

Preterm

Question 1

Newborn Mortality: placental insufficiency

Answer 1

Fetal

Question 2

Newborn Mortality: Respiratory distress syndrome

Answer 2

Preterm

Question 3

Newborn Mortality: congenital anomalies

Answer 3

Fullterm

Question 4

Newborn Mortality: intrauterine infection

Answer 4

Fetal

Question 5

Newborn Mortality: severe congenital malformations

Answer 5

Fetal

Question 6

Newborn Mortality: birth asphyxia, trauma

Answer 6

Fullterm

Question 7

Newborn Mortality: intraventricular hemorrhage

Answer 7

Preterm

Question 8

Newborn Mortality: Congenital anomalies

Answer 8

Preterm

Question 9

Newborn Mortality: infection

Answer 9

Full term & Preterm

Question 10

Newborn Mortality: umbilical cord accident

Answer 10

Fetal

Question 11

Newborn Mortality: abruptio placenta

Answer 11

Fetal

Question 12

Newborn Mortality: meconium aspiration pneumonia

Answer 12

Fullterm

Question 13

Newborn Mortality: necrotinizing enterocolitis

Answer 13

Preterm

Question 14

Newborn Mortality: persistent pulmonary hypertension

Answer 14

Fullterm

Question 15

Newborn Mortality: bromchopulmonary dysplasia

Answer 15

Preterm

Question 16

Newborn Mortality: hydrops fetalis

Answer 16

Fetal

Question 17

RDS type II. Prematures or term infants. Delayed absorption of respiratory fluid. Onset is early. Tachypnea with grunting or reactions, cyanosis. Difficult to differentiate from mild RDS. Feeding withheld.

Answer 17

Transient Tachypnea of the NB

Question 18

TTNB CXR: increase pulmonary markings, __________.

Answer 18

Overaeration

Question 19

Tx for TTNB

Answer 19

Oxygen by mask or hood

Question 20

Recovery period of TTNB

Answer 20

3-4 days

Question 21

Hyaline membrane disease. Common in premature. 60-80%

Answer 21

Respiratory Distress Syndrome

Question 22

Within minutes of birth. Peak within 3 days.

Answer 22

BS, fine rales

Question 23

RDS CXR: ______ glass, reticulogranular, air bronchogram; appears _____ hours.

Answer 23

Ground. 6-12.

Question 24

ABG result of RDS

Answer 24

Respiratory-metabolic acidosis, hypoxemia

Question 25

Is standard of car in women with preterm labor of up to 34weeks

Answer 25

Antenatal steroids

Question 26

For intratracheal instillation every 6-12 hrs for 2-4 doses

Answer 26

Exogenous surfactants

Question 27

Basic defect in Tx: decrease exchange of _________.

Answer 27

O2 & CO2

Question 28

RDS has high risk for

Answer 28

Pneumothorax

Question 29

Common complication of RDS

Answer 29

BPD

Question 30

10-15% of births. Stained. Term or post term. MAS in 5%. 30% mechanical ventilation, 3-5% expire. Tachypnea, retractions, grunting & cyanosis. Partial obstruction of some airways may lead to pneumothorax.

Answer 30

Meconium Aspiration

Question 31

Meconium Aspiration usually improves within

Answer 31

72hours

Question 32

Meconium stain CXR: patchy _______, course streaking BLF, anteroposterior diameter & ________ of diaphragm.

Answer 32

Infiltrates. Flattening.

Question 33

Prevention for Meconium aspiration

Answer 33

Careful anticipation

Question 34

Treatment for meconium stain

Answer 34

Supportive care & mgt of RDS

Question 35

Prognosis of Meconium Aspiration: depends on CNS injury from ________.

Answer 35

Asphyxia

Question 36

Is observed during the first week of life in 60% term infants & 80% preterm infants. When the rate of bilirubin production exceeds the rate of elimination, the end result is an increase total serum bilirubin(TSB) _________. Accumulation of bilirubin in the skin, sclera & mucosa.

Answer 36

Jaundice. Hyperbilirubinemia.

Question 37

Risk Factor of Jaundice: a sibling with neonatal _______ or _______.

Answer 37

Jaundice. Anemia.

Question 38

Risk Factor of Jaundice: Unrecognized _______ (ABO, Rh)

Answer 38

Hemolysis

Question 39

Risk Factor of Jaundice: nonoptimal ________ (bottle or breastfeeding)

Answer 39

Feeding

Question 40

Risk Factor of Jaundice: deficiency of _______.

Answer 40

G6PD

Question 41

Risk Factor of Jaundice: Infection. Infant of ______ mother. Immaturity.

Answer 41

Diabetic

Question 42

Risk Factor of Jaundice: __________. East asian, __________.

Answer 42

Cephalohematoma. Mediterranean.

Question 43

Jaundice is higher in populations living at

Answer 43

Higher altitudes

Question 44

Benign neonatal bilirubinemia. Nonpathologic condition due to increased bilirubin production and limited elimination. 17-18mg/dL

Answer 44

Physiologic Jaundice

Question 45

Exclusion criteria Physiologic Jaundice: jaundice persisting _______(full term)

Answer 45

>2wks

Question 46

Occurs within 1st week of life. 12.9% incidence. Bilirubin level >12mg/dL.

Answer 46

Breastfeeding Jaundice

Question 47

Occurs after 1st week of life. 2-4% incidence. Bilirubin >10mg/dL at 3 weeks.

Answer 47

Breastmilk Jaundice

Question 48

Among the infants with jaundice appearing on day 4 & 7 of life, _________ was more common cause, occurring in 50% of cases.

Answer 48

BM jaundice

Question 49

ABO incompatibility. G6PD. Sepsis. Infants of diabetic mothers. Visible jaundice 5-7mg/dL. TSB levels >12mg/dL appear jaundiced.

Answer 49

Unconjugated Hyperbilirubinemia

Question 50

Unconjugated HyperB Dx: total ______ bilirubin

Answer 50

Serum

Question 51

Unconjugated HyperB Dx: blood type & ____ status

Answer 51

Rh

Question 52

Unconjugated HyperB Dx: ______ & differential

Answer 52

CBC

Question 53

Unconjugated HyperB Dx: detects antibodies bound to the surface of RBC. Usually + in hemolytic disease. Does not correlate w/ severity of jaundice. Can be obtained from the cord blood.

Answer 53

Coombs test

Question 54

Elevation suggests hemolytic disease. Can also be elevated in cases of occult or overt hemorrhage.

Answer 54

Reticulocytes

Question 55

Management of Unconjugated H with side effect of bronze baby syndrome

Answer 55

Phototherapy

Question 56

Management of Unconjugated H when the risk of kernicterus is significant

Answer 56

Exchange transfusion

Question 57

Management of Unconjugated H pharmacologic therapy. Enhances bilirubin secretion.

Answer 57

Phenobarbital

Question 58

In Unconjugated H, presence of this suggests the prognosis is bad. There is neuronal dysfunction and death.

Answer 58

Kernicterus

Question 59

Increase in polyhydramnios, preeclampsia, pyelonephritis, preterm labor & chronic HPN. Usually LGA. Mortality rate is >5%. Clinical manifestations are large & lump, puffy plethoric facies, hypoglycemia, hypocalcemia, jittery, tremulous, tachypnea, inc RDS, cardiomegaly, birth trauma & congenital anomalies.

Answer 59

Infant of Diabetic Mother

Question 60

Treatment of Infant diabetic mother: ________ within 1hr & every 6-8hrs.

Answer 60

Blood glucose

Question 61

Treatment of Infant diabetic mother: _________ feeding soonest

Answer 61

Oral or gavage